SAPIEN HEART VALVE RECEIVES APPROVAL FROM FDA FOR EXPANDED ACCESS

The Wall Street Journal (9/23, Stynes, Subscription Publication, 5.91M) reports that the Sapien heart valve by Edwards Lifesciences Corp. was approved by the Food and Drug Administration to expand access to the valve for inoperable aortic valve stenosis patients.

        

The AP (9/24) reports the Sapien heart valve “is approved for patients who face major risks from open-heart surgery or who are too sick to have that procedure done.” The original labeling on the device “instructed surgeons to thread the valve into place through a major artery that runs from the leg up to the heart.” Under the new approved labeling, that language is removed, “allowing surgeons to choose from multiple methods of implantation.”

        

Forbes (9/24, 6.03M) contributor Larry Husten writes that “the most significant part of the FDA’s announcement may be not the label change itself but the source of the data supporting the claim, the Transcatheter Valve Therapy Registry (TVTR).” This registry, “which is run by the American College of Cardiology and the Society of Thoracic Surgeons, has emerged as an model of cooperation between the FDA, industry, and medical organizations.” In a press release, director of the FDA Center for Devices and Radiological Health, Jeffrey Shuren said, “Leveraging clinical research inside the framework of a device registry to expand access to therapy for more patients is a new paradigm for the FDA, researchers, registry sponsors and the medical device industry.”

POSTED BY: Steven Almany M.D.

HOW EXACTLY ARE DENTAL HYGIENE AND HEART CONDITIONS RELATED?

They are indirectly related.  There has been some connections between dental health and heart disease.  The two basic insights are inflammation and bacterial plaque.  Inflammation of the gums, gingivitis or advance periodontal disease, can lead to inflammation in other body sites, like the heart.  These can lead to chronic conditions.  Bacteria found in the month has been found in the heart (blood borne).

POSTED BY:  Steven Ajluni, MD

MEET THE MHG PHYSICIAN EXTENDERS, AN EXTENSION OF YOUR HEART CARE TEAM! THIS MONTH WE RECOGNIZE ANITA JURIGA!

Beaumont Michigan Heart Group would like to introduce you to our physician extenders.  They are a critical part of the Cardiology team at Michigan Heart Group.  The Physician Extenders work hand and hand with the physicians, making decisions on the best treatment options for each patient on a case by case basis.  All of our extenders round on the weekends as well as work in the hospital during the week.  Most of our extenders also have have office hours and we encourage our patients to feel comfortable following up with them in the office.  Our medical decisions are often a team approach that each extender is a part of and they are often at the forefront of each decision that is made.

The practice is made up of Interventionist (plumbers) and Electrophysiologist (electricians).  The plumbers are located at 4600 Investment Drive, #200, while the Electricians are in the building next door at 4550 Investment Dr., #250.  In addition Michigan Heart Group has two satellite offices to accommodate our out of town patients.  One in Macomb at 15959 Hall Road, #304, Macomb and another in Novi at Ten Mile and Haggerty, 39500 Ten Mile, #103, Novi. Each extender is trained and familiar with both specialties however all but one currently they only see patients at our 2 main locations.

Each month we will be focusing on one extenders achievements, this month we recognize Anita Juriga.

Anita Juriga, MSN, A.P.R.N:  Anita joined Michigan Heart Group in October 1995.  She went to Michigan for her Bachelor of Science in Nursing and continued on at Oakland for her Masters.  Anita is certified by the American Nurses Credentialing Center as a Clinical Nurse Specialist.  Her office is at Michigan Heart Group with office hours all day Tuesday and Thursday.  If you don’t meet Anita in the office, you may meet her at William Beaumont Hospital- Troy.  She is one of three main rounder’s for that hospital and when not in the office you will find her at the hospital. 

OUR EXTENDER TEAM AND WHERE YOU MAY SEE THEM:

Cheryl Vincent, MSN, A.P.R.N: Sees patients at Michigan Heart Rhythm group all day Thursday and Friday.  Also, sees patients at William Beaumont Hospital- Troy, covers Beaumont RO when needed.

Anita Juriga, MSN, A.P.R.N:  Sees patients at Michigan Heart Group all day Tuesday, Thursday and Friday.  Also, sees patients at William Beaumont Hospital- Troy, covers Beaumont RO when needed.

Howard Hollinger, P.A.-C.:  Sees patients at Michigan Heart Group all day Monday and Tuesday.  Also, sees patients at William Beaumont Hospital- Troy, covers Beaumont RO when needed.

Debby Goodall, A.P.R.N, A.N.P.-B.C.:  Sees patients at Michigan Heart Group on Monday afternoons and at Michigan Heart Rhythm Group on Friday afternoons.  Also, sees patients at William Beaumont Hospital- Troy, covers Beaumont RO when needed.

Michelle Forcina, P.A.-C.:  Sees patients at Michigan Heart Rhythm Group all day Mondays and Tuesdays and in the morning on Wednesdays.  Rounds at both William Beaumont Hospital- RO and Troy on the weekends.

Dawn Mitchell, A.C.N.P.:  Sees patients at Michigan Heart Group all day Wednesdays.  Also,  sees patients at William Beaumont Hospital- Royal Oak, covers Beaumont Troy when needed.

Lily Paciorkowski, R.N., MSN:   Sees patients at William Beaumont Hospital- Royal Oak, covers Beaumont Troy when needed.

Mariann Graham, R.N., BSN:  Sees patients at William Beaumont Hospital- Royal Oak, covers Beaumont Troy when needed.

We are very fortunate to have such a great, caring and educated team working with us.  They look forward to meeting you and we hope you look forward to meeting them.

Thank you!
The Beaumont Michigan Heart Group Physicians

GROUP RELEASES NEW DEFINATION FOR MI FOLLOWING CORONARY REVASCULARIZATION

MedPage Today (10/15, Neale, 122K) reports that “the Society for Cardiovascular Angiography and Interventions (SCAI) has released a new definition for myocardial infarction (MI) following coronary revascularization” intended to identify “only those events likely to be related to poorer patient outcomes.” In this new definition, which is “published as an expert consensus document in Catheterization and Cardiovascular Interventions and the Journal of the American College of Cardiology...creatine kinase-myocardial band (CK-MB) is the preferred cardiac biomarker over troponin, and much greater elevations are required to define a clinically relevant MI compared with the universal definition of MI proposed in 2007 and revised in 2012.” Additionally, “the new definition uses the same biomarker elevation thresholds to identify MIs following both percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG), whereas the universal definition has different thresholds for events following the two procedures.”

        

CardioSource (10/15, 2K) reports, “An accompanying editorial by Harvey White, DSC, FACC, from the Green Lane Cardiovascular Service, Auckland City Hospital, New Zealand, argues that there may be negative unintended consequences for having different definitions.” White “adds that ‘CK-MB is now unavailable in an increasing number of hospitals. With CK-MB becoming obsolete, troponin will become the gold standard, and CK-MB will no longer have a role in defining PCI injury and infarction in clinical practice.’”

       

MedScape (10/15, Wood, 164K) reports that lead author Dr Issam Moussa “is quick to emphasize that these new clinically meaningful definitions have limited evidence to support them – and most of what exists supports CK-MB definitions, not cTn – but that the new document is based on the best scientific evidence available.”

POSTED BY:  Steven Almany M.D.

NEW GUINNESS WORLD RECORD SET FOR HEART TRANSPLANT PATIENTS

February 14th was a very special day for the heart.  Not because of the candy, chocolate and flowers.  Because 132 heart transplant patients gathered at Art Moran Buick GMC in Southfield to set Guinness World Record for largest gathering of heart transplant recipients.  Just 50 were needed to break the record.  Officials said this was the first attempt at such a record.

This accomplishment was also a tribute to American Heart Month, which celebrated its 50th anniversary this year after being signed into law by President Lyndon Johnson in 1964.

Participants included Transplant centers at University of Michigan Health System, Henry Ford Health System, Children’s Hospital of Michigan, Beaumont Health System, Spectrum Health System, Cleveland Clinic and the Cincinnati Children’s Hospital Medical Center.

Our own Dr. William Devlin from Michigan Heart Group in Troy played an important role as an official counter of the transplant patients.  There were also several Michigan Heart Group patients there supporting the event.  Some of them transplant patients themselves.

Included in the count was John Payne, 66 of Detroit, the longest living heart transplant recipient in Michigan, who received his heart 27 years ago at Henry Ford Hospital; a 30 year recipient from Stanford; and a 3 month, 7 day infant.  The gift of transplant has given 1318 years of additional life to the 132 transplant patients counted.

Currently, there are 3,000 people in Michigan waiting for an organ transplant.  One organ donor can save the lives of eight people, and with the eyes and tissue donations, one person can improve the lives of up to 50 people!!!

Tom Moran, president of Art Moran Buick GMC, has been promoting organ donation at his dealership for more than a year, and is offering a free car was to anyone who signs up for the donor registry at the dealership.

More than 3 million people have been added to Michigan's Organ Donor Registry since its inception.  45% of adults in Michigan are registered today which is up from 27% in 2011. People can join the Donor Registry Online or call (800) 482-4881.

POSTED BY:  Stacie Batur

3 MICHIGAN HEART GROUP PHYSICIANS AND NEARLY 260 BEAUMONT PHYSICIANS NAMED TO 2014 BEST DOCTORS IN AMERICA LIST

Recently 257 Beaumont physicians appear on the Best Doctors in America® List for 2014, including physicians from all three Beaumont hospitals.  Three of those physicians where Michigan Heart Group Physicians, Drs Steven Almany, Steven Ajluni and Brian Williamson.  Congratulations to all these Beaumont Physicians for making the list.

Only five percent of doctors in America earn this honor, decided by impartial peer review.

This recognition is another indication of the high quality of Beaumont doctors. It’s an honor that so many of our physicians have been selected by their peers to appear on this list.

Assembled by Best Doctors, Inc. and audited and certified by Gallup, the Best Doctors in America® List results from polling more than 45,000 physicians in the United States. Doctors in more than 450 specialties and subspecialties of medicine appear on this year’s list. In a confidential review, physicians currently on the list answer the question, “If you or a loved one needed a doctor in a certain specialty, who would you choose?” Best Doctors, Inc. evaluates the results and verifies all additional information to meet detailed inclusion criteria.

Doctors cannot pay to be included in the Best Doctors database, nor are they paid to provide their input. The list is a product of validated peer review, in which doctors who excel in their specialties are selected by their peers in the profession.

  

You can see a list of all Beaumont Physicians named this year by visiting the Beaumont Doctor Online physician website. For more information, visit Best Doctors at www.bestdoctors.com

POSTED BY: Stacie Batur, Physician Liaison

Stats and Information about Best Doctors taken from letter by:
David Wood, M.D.

Chief Medical Officer

Beaumont Hospitals

ARE YOU VACCINATED? WHOOPING COUGH (PERTUSSIS) HAS BEEN A COMMON DIAGNOSIS THIS WINTER.

Whooping cough- known medically as pertussis- is a highly contagious respiratory tract infection.  Although it initially resembles an ordinary cold, whooping cough may eventually turn more serious, particularly in infants.  The best way to prevent it is through vaccinations.  The childhood vaccine is called DTaP.  The whooping cough booster vaccine for adolescents and adults is called Tdap.  Both DTaP and Tdap protect against whooping cough, tetanus and diphtheria.  Recommended vaccine ages are listed below:

Age/Status	Recommendations
Birth through 6 years	DTaP is routinely recommended at 2, 4, and 6 months, at 15 through 18 months, and at 4 through 6 years.
7 through 10 years	Tdap is recommended for children ages 7 through 10 years who are not fully vaccinated (see not 1) against pertussis: ·         Single dose of Tdap for those not fully vaccinated or ·         If additional doses of tetanus and diphtheria toxoid-containing vaccines are needed, then children aged 7 through 10 years should be vaccinated according to the catch-up schedule, with Tdap preferred as the first dose.
11 through 18 years	Tdap is routinely recommend as a single dose for those 11 through 18 years of age with preferred administration at 11 through 12.  If adolescents (13-18 miss getting Tdap at 11-12 yrs. then administer at the next patient encounter or sooner if that adolescent has close contact with infants.
19 years and older	Andy adult 19 yrs. of age or older who has not received a dose of Tdap should get one as soon as feasible- to protect themselves and infants.  This Tdap booster dose can replace one of the 10-year Td booster doses.  Tdap can be administered regardless of interval since the previous Td dose.  Shorter intervals between Tdap and last Td may increase the risk of mild local reactogenicity but may be appropriate if your patient is at high risk for contracting pertussis, such as during an outbreak, or has close contact with infants.
Pregnant women	Pregnant women should get a dose of Tdap during each pregnancy, preferable at 27 through 36 weeks gestation.  By getting Tdap during pregnancy, maternal pertussis antibodies transfer to the newborn, likely providing protection against pertussis in early life, before the baby starts getting DTaP vaccines.  Tdap will also help protect the mother at time of deliver, making her less likely to transmit pertussis to her infant.  It is important that all family members and caregivers of the infant are up-to0date with their pertussis vaccines (DTaP or Tdap, depending on age) before coming into close contact with the infant.
Health Care Personnel	A single dose of Tdap is recommended for health care personnel who have not previously received Tdap as an adult and have direct patient contact.  Tdap vaccination can protect health care personnel against pertussis and help prevent them from spreading it to their patients.  Priority should be given to vaccinating those who have direct contact with babies younger than 12 months. Tdap can be administered regardless of interval since the previous Td dose.  However, shorter intervals between Tdap and last Td may increase the risk of mild local reactogenicity.

Taken from the CDD at http://www.cdc.gov/Vaccines/vpd-vac/pertussis/default.htm

POSTED BY: Ilana Kutinsky, DO 

RENAL DENERVATION MAY NOT BE AS BENEFICIAL WHEN ACCESSORY RENAL ARTERIES ARE PRESENT

MedPage Today (10/22, Neale, 122K) reports that research published in JACC: Cardiovascular Interventions suggest that “the blood pressure-lowering effects of renal denervation may not be as great when accessory renal arteries are present.”  Investigators found that “the average office blood pressure reduction after 6 months was 16.6/6.7 mm Hg (P < 0.02) in patients with single renal arteries feeding each kidney- considered the optimal anatomy for the procedure- and only 6.2/0.2 mm Hg (P=NS) in those with additional arteries.” The researchers found that “in the latter group, there was no significant effect of the procedure even if all of the accessory arteries were denervation, although the difference in blood pressure reduction between patients with single renal arteries and those with denervation of all accessory arteries was not statistically significant.

HEART HEALTHY RECIPE- POTATO SALAD

Summer salads made with mayonnaise can be enjoyed if they are trimmed down.  If you have been using low-fat mayonnaise, go that extra step and use the fat-free variety. 

Potato Salad

                

1 lb. medium round white potatoes, scrubbed

 3 c. water

 ¼ c. finely chopped green onions

 ¼ c. finely chopped red bell pepper

 ½ c. chopped celery

 1/3 c. fat-free mayonnaise

 2 T. plain nonfat yogurt

 1 tsp. prepared mustard

 1 tsp. horseradish

 1/8 tsp. white pepper

 Dash of paprika

 1/4 c. shredded carrots

In a large saucepan, combine the whole unpeeled potatoes and water.  Bring to a boil.  

Reduce heat and simmer until tender, about 35 minutes.  Drain the potatoes.  Cut into cubes and set aside. 

In a large bowl combine the green onion, red bell pepper, celery and cubed potatoes.  Chill for at least 2 hours. 

In a small bowl, mix together the mayonnaise, yogurt, mustard, horseradish and white pepper.  Pour the mixture over the chilled vegetables and toss gently to evenly coat.  Sprinkle with paprika on top and garnish with shredded carrots.

Nutrition Information:  per 1/6 recipe

Calories 86, Total fat trace g, Cholesterol 0 mg, Sodium 206 mg, Carbohydrate 20 g, Fiber 1.5 g, Sugar 2 g, Protein 2g

IS IT POSSIBLE FOR A 23 YEAR OLD TO HAVE A HEART ATTACK?

Heart attacks represent sudden occlusion of a coronary artery.  This happens most commonly because of atherosclerotic plaque rupture, although other things (like coronary spasm, cocaine use, and vasculitis, etc.) need to be considered, particularly in a 23 year old.  Traditional risk factors might be less applicable.

POSTED BY:  Steven Ajluni, MD

HEART HEALTHY RECIPE- TOMATOES AND ZUCCHINI

Tomatoes and Zucchini


Vegetable oil cooking spray
1 large onion, thinly sliced

         1 clove garlic, minced
         4 med tomatoes, peeled, cored, coarsely chopped

         2 medium zucchini, thinly sliced

         ½  med green pepper, cored, seeded, chopped
         1½  tsps. fresh basil, dried, finely chopped; or 
                                                                ½ tsp. dried
          ¼ tsp. freshly ground black pepper

          2 T. freshly grated Parmesan cheese
          2 T. fresh parsley, dried, chopped; or 
                                                                                                                                          2 tsps. dried

         Spray a large skillet with the cooking spray.  Add the onion and garlic and sauté until the onion is tender but not brown, stirring occasionally, about 3 to 4 minutes.  Stir in the tomatoes, zucchini, green pepper, basil and pepper.  Cover and simmer for 10 minutes or until the zucchini is tender, stirring occasionally.  Uncover and simmer about 5 minutes, or until most of the liquid evaporates.  Sprinkle with Parmesan cheese and garnish with parsley before serving.

Nutrition Information:  per 1/6 recipe
Calories 48, Total fat 1 g, Saturated  fat 0.5 g, Cholesterol 2 mg, Sodium 49 mg, Carbohydrate 7 g, Fiber 2.5 g, Sugar 4 g, Protein 3 g

2/11/14- DR. WILLIAMSON AND STAFF WILL SEE PATIENTS AT 4600 INVESTMENT DRIVE, STE 200

On 02/11/14 Dr. Williamson, Michelle Forcina PA-C and Device Specialist Jan and Amy, will see his patients at our Diagnostic Center on the main campus in Troy.  

The address is 4600 Investment Drive, Ste 200 Troy MI.  It is the building directly west of where he regularly sees his patients.  Sorry for any inconvenience this may cause you.

Management

NOVI OFFICE, CELEBRATES ONE YEAR!

Western Wayne Heart Group is celebrating 1 year at our Novi location at 10 Mile and Haggerty.  This is minutes from all the express ways.

39500 Ten Mile Road
Suite 103
Novi, MI 48375
Phone: (248) 267-5050
Fax: (248) 267-5051

Please see the link below for directions for our old office in Livonia to the new office in Novi.
http://goo.gl/maps/6h7hq

Our Novi office allows for the same expert standard of testing and care you've come to expect from us, with the benefits of being uploaded directly into Beaumont's Epic within 48 hours.  No mail, no faxes and no need for scanning.  We also have state of the art equipment which provides safer, more accurate testing.

If you have visited our Novi office we hope you are as happy with our it as we are.  Should you have any questions or concerns please don't hesitate to call our Physician Liaison Stacie Batur.  She can help stream line communications between referring physicians, bring cards to your office (if you're a physician), or simply answer a question.  She can be reached at the numbers below:

Office: (248) 267-5050 (x6509); Primarily Mondays and Thursdays

Mobile: (248)765-4466;  Tuesdays and Wednesdays

STUDY SAYS MEDITERRANEAN-STYLE DIET MAY IMPROVE HEALTH IN LATER LIFE

The Washington Post (11/4, Searing, 4.28M) reports a Mediterranean-style diet could “improve health in later life,” citing the Nov. 5 issue of Annals of Internal Medicine. The Post says researchers “analyzed data on 10,670 women, most in their late 50s and generally healthy.” Researchers assessed their mental and physical status, as well as dietary patterns, periodically over the next 15 years. Those who consumed more “plant-based foods (fruits, vegetables and nuts)” and “less red and processed meats, and moderate amounts of alcohol” had “about a 40 percent greater chance of living beyond age 70,” with a healthy life, compared to those whose diets were least like Mediterranean.

        

Forbes (11/4, Husten, 6.03M) provides details of the study, noting that “compared to women with the lowest diet scores, women with diet scores in the highest quintile had a 61% to 80% increase in the odds of becoming a ‘healthy ager.’” The article says taking into account other known risk factors, “the women in the highest quintile had a 34%-46% increase,” with the trends all highly significant. Moreover, the healthy agers “also had less hypertension and hypercholesterolemia, exercise more, and were less likely to be obese or to smoke.”

POSTED BY: Steven Almany M.D.

HEART HEALTHY RECIPE- PORK CHOPS WITH HONEY and GARLIC

Pork Chops with Honey and Garlic

Vegetable oil spray

4 center loin pork chops (5 oz. each), fat removed

¼ c. honey

¼ c. lemon juice

2T. light soy sauce

½ tsp. bottled minced garlic

Spray a large skillet with vegetable oil.  Place over medium-high heat.  Add pork chops to hot skillet and brown for 1 minute on each side.  Reduce heat to medium and cook about 8 minutes; turn and cook 5                                                                            minutes more or until done. 

While pork chops are cooking, stir together honey, lemon juice, soy sauce and garlic in a small bowl.  Remove pork chops from skillet when they are done and keep warm.  Add honey mixture to skillet and cook 3 minutes, stirring occasionally.  Pour over pork chops.

Nutrition Information:  per ¼ recipe

Calories 227, Total fat 9 g, Saturated fat 3 g, Cholesterol 58 mg, Sodium 348 mg, Carbohydrate 19 mg, Protein 18 mg   

MY 19 YO DAUGHTER HAS BEEN DIAGNOSED WITH LONG QT SYNDROME. WHAT TREATMENTS ARE POSSIBLE?

Beta blockers such as Inderal are usually the first line of treatment.

POSTED BY:  Steven Ajluni, MD

HEART HEALTHY RECIPE- TUNA CASSEROLE

Truly one of the great comfort foods, tuna casserole is both easy to prepare and delightfully satisfying.  Low-sodium water-packed tuna keeps the sodium contents of this dish at acceptable levels.

Tuna Casserole

                              

                                                                         8 oz. uncooked macaroni

Vegetable oil cooking spray

1 can (10 oz.) reduced-sodium condensed cream of       mushroom soup

½ cup chopped onion

1/8 tsp. pepper

1 pkg. (10 ½ oz.) frozen mixed vegetables

1 can (6 ½ oz.) low-sodium water-packed tuna,                  drained

1 T. Parmesan cheese

1 T. unseasoned bread crumbs

Preheat oven to 350.  Cook macaroni according to package directions, omitting salt.  Drain and set aside.  Spray a 2-quart casserole dish with cooking spray and set aside.

In a large bowl combine the cream of mushroom soup, onion, pepper, frozen mixed vegetables and tuna.  Mix well.  Stir in the cooked macaroni.  Pour the mixture into the prepared casserole dish and sprinkle top with Parmesan cheese combined with bread crumbs.  Bake for 30-35 minutes or until the sauce is bubbly and the crumb topping golden.

Nutrition Information:  per ¼ recipe

Calories 378, Total fat 4 g, Saturated fat 1.5 g, Cholesterol 23 mg, Sodium 390 mg, Carbohydrate 61 g, Fiber 3 g, Sugar 5 g, Protein 24 g

ARE YOU VACCINATED? WHOOPING COUGH (PERTUSSIS) HAS BEEN A COMMON DIAGNOSIS THIS WINTER.

Whooping cough- known medically as pertussis- is a highly contagious respiratory tract infection.  Although it initially resembles an ordinary cold, whooping cough may eventually turn more serious, particularly in infants.  The best way to prevent it is through vaccinations.  The childhood vaccine is called DTaP.  The whooping cough booster vaccine for adolescents and adults is called Tdap.  Both DTaP and Tdap protect against whooping cough, tetanus and diphtheria.  Recommended vaccine ages are listed below:

Age/Status	Recommendations
Birth through 6 years	DTaP is routinely recommended at 2, 4, and 6 months, at 15 through 18 months, and at 4 through 6 years.
7 through 10 years	Tdap is recommended for children ages 7 through 10 years who are not fully vaccinated (see not 1) against pertussis: ·         Single dose of Tdap for those not fully vaccinated or ·         If additional doses of tetanus and diphtheria toxoid-containing vaccines are needed, then children aged 7 through 10 years should be vaccinated according to the catch-up schedule, with Tdap preferred as the first dose.
11 through 18 years	Tdap is routinely recommend as a single dose for those 11 through 18 years of age with preferred administration at 11 through 12.  If adolescents (13-18 miss getting Tdap at 11-12 yrs. then administer at the next patient encounter or sooner if that adolescent has close contact with infants.
19 years and older	Andy adult 19 yrs. of age or older who has not received a dose of Tdap should get one as soon as feasible- to protect themselves and infants.  This Tdap booster dose can replace one of the 10-year Td booster doses.  Tdap can be administered regardless of interval since the previous Td dose.  Shorter intervals between Tdap and last Td may increase the risk of mild local reactogenicity but may be appropriate if your patient is at high risk for contracting pertussis, such as during an outbreak, or has close contact with infants.
Pregnant women	Pregnant women should get a dose of Tdap during each pregnancy, preferable at 27 through 36 weeks gestation.  By getting Tdap during pregnancy, maternal pertussis antibodies transfer to the newborn, likely providing protection against pertussis in early life, before the baby starts getting DTaP vaccines.  Tdap will also help protect the mother at time of deliver, making her less likely to transmit pertussis to her infant.  It is important that all family members and caregivers of the infant are up-to0date with their pertussis vaccines (DTaP or Tdap, depending on age) before coming into close contact with the infant.
Health Care Personnel	A single dose of Tdap is recommended for health care personnel who have not previously received Tdap as an adult and have direct patient contact.  Tdap vaccination can protect health care personnel against pertussis and help prevent them from spreading it to their patients.  Priority should be given to vaccinating those who have direct contact with babies younger than 12 months. Tdap can be administered regardless of interval since the previous Td dose.  However, shorter intervals between Tdap and last Td may increase the risk of mild local reactogenicity.

Taken from the CDD at http://www.cdc.gov/Vaccines/vpd-vac/pertussis/default.htm

POSTED BY: Ilana Kutinsky, DO